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About That Year-Long "Critical" Saline Shortage

Tyler Durden's picture




 

In addition to its previously discussed farcical seasonal adjustment that made a slumping unadjusted Employment index appear as if it was the highest in adjusted series history, which brought a smile to many faces, today's Non-manufacturing PMI report had a far more curious datapoint that slipped largely under the radar: the ISM's disclosure of the "commodities in short supply."

Two of these were also quite comical.

One was labor, which would be a required condition to complete the spin of surging seasonally-adjusted labor conditions, however which would promptly dissolve into a puff of propaganda upon a quick glance at the other set of data, the one showing real hourly wages, and the fact that these have declined in 6 of the past 7 months (and since the data comes from the BLS using an incorrect estimation of inflation, the real wage situation is far more dire). So sadly, judging by the lack of rising wages, a labor shortage is the last thing the ISM's goalseeked respondents have to worry about.

 

The second commodity in short supply makes far more sense: ammunition. Because one can only assume that for the second month in a row, all those 100+ million Americans that are out of the labor force or unemployed have to spend their time doing something. Shooting is as good a hobby as any.

But it was the third commodity that has been in short supply that caught our attention: a shortage that has lasted for 10 months now, or throughout all of 2014: medical IV solutions, aka saline.

A shortage of saline? And not just a shortage, but according to the FDA, a "critical shortage, which poses a serious threat to patients." For some perspective on this quite peculiar shortage we go to the source: the US Food and Drug Administration, where we read in reverse chronological order.

[10/16/2014] In response to the ongoing shortage of 0.9% sodium chloride injection (normal saline), B. Braun Medical Inc. of Bethlehem, Pa., will temporarily distribute normal saline in the United States from its manufacturing facility in Germany. FDA is temporarily exercising its discretion regarding the distribution of B. Braun’s saline product from Germany, in addition to Baxter’s saline product from Spain and Fresenius Kabi’s saline product from Norway, to help address this critical shortage, which poses a serious threat to patients.

 

FDA inspected B. Braun’s facility in Melsungen, Germany where its normal saline product is made to ensure the facility currently meets FDA standards. FDA asks that health care professionals contact B. Braun directly to obtain the product. 

 

In addition to this source of normal saline as well as B.Braun’s normal saline that is manufactured in the U.S. , FDA will continue working with Baxter Healthcare Corp., Fresenius Kabi USA, LLC., and Hospira Inc. while they continue distributing their respective saline products and  seek to restore their supply of normal saline for U.S. hospitals and health clinics.

 

While the shipments described above continue to help reduce current disruptions, they will not resolve the current shortage of 0.9% sodium chloride injection.  Preventing drug shortages is a top priority for the FDA, and we are doing everything within our authority to alleviate this and other drug shortages.

 

[04/28/2014] In response to the ongoing shortage of 0.9% sodium chloride injection (normal saline), Baxter Healthcare Corp. of Deerfield, Ill., will temporarily distribute normal saline in the United States from its Spain manufacturing facility. FDA is temporarily exercising its discretion regarding the distribution of Baxter’s saline product from Spain and Fresenius Kabi’s saline product from Norway as needed to address this critical shortage, which poses a serious threat to patients.

 

FDA inspected Baxter’s Spain facility where its normal saline product is made to ensure the facility meets FDA standards. FDA asks that health care professionals contact the Baxter directly to obtain the product.

 

In addition to these sources of normal saline, U.S.-based manufacturers – Baxter Healthcare Corp. , B.Braun Medical Inc., and Hospira Inc., – are currently producing and releasing normal saline. Baxter’s saline product from Spain will be distributed temporarily in addition to Baxter’s FDA-approved version that is currently manufactured and distributed in the United States.

 

While the shipments described above will help reduce current disruptions, they will not resolve the current shortage of 0.9% sodium chloride injection. Preventing drug shortages is a top priority for the FDA, and we are doing everything within our authority to improve access and alleviate this shortage.

 

[03/28/2014] Due to the shortage of 0.9% sodium chloride injection (normal saline) Fresenius Kabi USA, LLC of Lake Zurich, Ill., will temporarily distribute normal saline in the United States from its Norway manufacturing facility. FDA is temporarily exercising enforcement discretion for the distribution of Fresenius Kabi USA’s normal saline product while it is needed to address this critical shortage that directly impacts patients.

 

FDA inspected Fresenius Kabi’s Norway facility where its normal saline product is made to ensure the facility meets FDA standards. FDA asks that health care professionals contact the Fresenius Kabi USA directly to obtain the product.

 

Hospitals and health clinics nationwide rely on normal saline to treat patients with hydration and other medical needs.

 

While these initial shipments will help, they will not resolve the shortage. However, FDA is working closely with manufacturers to meet the needs for normal saline across the U.S. in the coming weeks.

 

FDA will continue working with Baxter Healthcare Corp., B.Braun Medical Inc., and Hospira Inc. as they seek to restore their supply of normal saline for U.S. hospitals and health clinics. In addition, FDA is working with Fresenius Medical Care, which supplies normal saline to dialysis centers.

 

FDA remains committed to doing everything it can to address this shortage. While FDA cannot require a manufacturer to produce a product, the agency will continue to use all the tools at its disposal to mitigate this and other drug shortages.

And the very first FDA notice, together with the supposed reason for this saline shortage:

[01/17/2014] FDA is aware of the shortage situation for intravenous (IV) solutions, particularly 0.9% sodium chloride injection (i.e., saline) used to provide patients with the necessary fluids for hydration and other conditions. The shortage has been triggered by a range of factors including a reported increased demand by hospitals, potentially related to the flu season.

 

We are working with the three manufacturers of these products, Baxter Healthcare Corp., B.Braun Medical Inc., and Hospira Inc., to help preserve the supply of these necessary products. Addressing this shortage will depend on the increased demand and the manufacturing production of the current suppliers. Millions of these I.V. solutions are used each week by health care professionals.

Bottom line: a saline shortage that is "Potentially related to the flu season." A shortage, which according to the ISM is now in its 10th month. That must have been some flu season.

Then again, counting back from October, the first month when there was a saline shortage was in January of this year (as confirmed here), when incidentally there wasn't much if any major flu outbreak as most people were staying home and away from the infamous Polar Vortex.

Yet one key event did take place just around January of 2014. The WHO reminds us what:

On 26 December 2013, a 2-year-old boy in the remote Guinean village of Meliandou fell ill with a mysterious illness characterized by fever, black stools, and vomiting. He died 2 days later. Retrospective case-finding by WHO would later identify that child as West Africa’s first case of Ebola virus disease. The circumstances surrounding his illness were ominous.

Purely a coincidence, surely.

Then again, with flu season once again just around the corner, only this time with the added fear and threat of Ebola potentially on US soil, where the tiniest sneeze is likely to result in an ER visit, one can't help but wonder: what happens if indeed there is a major flu outbreak this winter (or worse). Just as one can't help but wonder: why and how can it be so difficult to restock on what is essentially plastic containers filled with water and 0.9% of salt thrown in?

 

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Wed, 11/05/2014 - 22:07 | 5417855 Newsboy
Newsboy's picture

If you are not turning the corner on day #5 of Ebola symptoms, your viral load is about to rise 100 fold, rupturing you and releasing virions.

IV saline helps those destined to live, not those destined to die.

Wed, 11/05/2014 - 22:21 | 5417926 kliguy38
kliguy38's picture

This is well known to all of us in the HC field and it is ludicrous......someone is stockpiling big time.... Saline cipro doxycycline zofran IV and other commonly used NEVER short before supplies .... someone

Wed, 11/05/2014 - 22:33 | 5417976 seek
seek's picture

Any steroids on that list?

I ask because that'd be a big clue about concerns over cytokine storms, which suggests it'd be ebola related.

Wed, 11/05/2014 - 22:54 | 5418066 NoDebt
NoDebt's picture

I'd like to throw a little hat tip out to Maskone909 who mentioned this Saline shortage in a post way back in a thread this morning.  It was certainly news to me.  I mean, really, how could the United States run out of something so simple as Saline?  That would be like running out of toilet paper (that comparison is not by accident).

I don't know if the Tylers got this idea from his post or if it's just coincidence, but Maskone909's post on the subject is half way down page 1:

http://www.zerohedge.com/news/2014-11-05/most-ridiculous-seasonal-adjust...

The digital world may depend on everything falling down the memory hole, but I remember and I think it's important to give credit where credit is due.

 

Wed, 11/05/2014 - 23:17 | 5418148 kchrisc
kchrisc's picture

"I mean, really, how could the United States run out of something so simple as Saline?"

More proof that centralization always fails.

An American, not US subject.

Thu, 11/06/2014 - 09:18 | 5418986 Cheduba
Cheduba's picture

Physical shortages will be a direct result of the complex globalized supply chain breaking down.

Remember how the tsunami in Japan shut down US automakers?   Now picture that on a global scale as suppliers of suppliers go bankrupt and inputs for manufacturing processes are no longer available.

Wed, 11/05/2014 - 23:58 | 5418271 BlindMonkey
BlindMonkey's picture

I used to work for the biggest medical supplier in the country.  The feds bought so much saline this year that hospitals were short and the "biggest hospital supplier" was basically rationing it to their customers.  

 

FWIW, that is second hand because I had already left when that happened but it is a highly reliable source that has direct knowledge of inventory levels.

Wed, 11/05/2014 - 23:34 | 5418201 cornflakesdisease
cornflakesdisease's picture

From a news forum clip back in July: "I work as a doctor (hospitalist), in west Texas and we have been experiencing severe shortage of IV solutions like normal saline, dextrose with water and medications such as solumedrol (a potent steroid), that are indispensable for patient care. Actually our hospital pharmacy has not been able to purchase normal saline iv solution nor dextrose with water for several weeks now. Our pharmacy is being told that this is also taking place in other hospitals throughout the country and they do not have a timeline for these items to be available again. This is clearly worrisome, the few times that I have seen this take place is just before a war, not even before a natural disaster. I think this is extremely important since these are very basic supplies that are much needed in a hospital and without them patient care is compromised."

Thu, 11/06/2014 - 00:31 | 5418343 seek
seek's picture

..."solumedrol (a potent steroid),"

It's actually "Solu Medrol." There's the smoking gun. It's methylprednisolone and a methylprednisolone "pulse" is what you use to keep the cytokine storm from killing an  patient having one (triggered, by, say ebola.) There was a shortage in 2012 due to contaminated medicine but to have it in 2014 is odd.


Thu, 11/06/2014 - 01:42 | 5418470 Miffed Microbio...
Miffed Microbiologist's picture

I would be interested what the cost is as well. When Obamacare passed we saw supplies increase up to 5x. Even the most basic of lab supplies.

We have been told this flu season is expected to be bad. We are stockpiling flu PCR reagents just anticipating this.

The problem with Ebola patients is they require FFP for coagulation factors other blood products. These have a limited expiration date vs saline which can keep sterile for a long time. Plus they require freezing and refrigeration.

This is another potential disaster waiting in the wings due to the fact we no longer manufacture most medical supplies. There are so many cases of drugs being adulterated world wide due to the cost of manufacturing. Heparin was a famous incidence resulting in deaths primarily in Germany. Healthcare's future looks bleak on so many fronts.

Miffed

Thu, 11/06/2014 - 04:51 | 5418677 Parrotile
Parrotile's picture

Here in "The Great Southern Land" we usually have shortages / insufficient supply, of at least a few things.  However at present it's nothing critical (along the lines of the major antibiotic supply problems we've had in the past - e.g. Tazocin (Puerto Rico Manufacuring problem led to Global shortage!)).

Whole Blood, and Blood products are mostly local (Australian Red Cross Blood Service) but we are having problems with Fondaparinux (for the HITS patients), and if there's ever a problem with Heparin / Enoxaparin we're really up the creek since so many customers come in with clots everywhere these days (Pulmonary embolism is THE big "Growth Area" here!), on top of anticoagulation demand for all the surgical / orthopaedic Patients ("supposed" to mobilise early often doesn't happen with the "larger" customer!).

It might be intersting if Lamivudine becomes the next big thing for Ebola chemotherapy - there's already a hardly-met demand for Hep C / HIV Patients, and with the active being a complex synthesis / recovery (active enantiomer - per the Pharmacist Mrs), the existing Global manufaturing capacity isn't great. So, maybe another rather more critical "shortage" in the future?

Who knows. Maybe we'll all be very lucky. Maybe we won't . . . . .

 

Thu, 11/06/2014 - 07:30 | 5418811 overmedicatedun...
overmedicatedundersexed's picture

miffed the generic drug exodus from USA to India is massive and the products from India are questionable..

one main DM drug Metformin the product from India has strong fish smell, not found in USA products which were pennies more than the Indian products..has me wondering about efficacy..one large generic indian company was banned by FDA from US market because of multiple violations of GMP..so did they fix their production plant? NO they went and bought another Generic co in India and are now use that co's  license to sell into the USA market.

the modern world wide NWO free trade model is based on low cost even a few pennies lower costs means USA co jobs go to the lowest cost areas, and our regs and honest producers here shut down. Good paying jobs making life saving drugs are gone, shortages are everywhere, the NWO thugs in DC are playing with the health of the USA and doing permanent damage to our skilled work force. (like this has not been said all over the internet for years and years..and here on ZH many times)

sterile Saline injection not available would have been unthinkable 30 yrs ago. now drug shortages are too common and people die for pennies.

Thu, 11/06/2014 - 13:22 | 5420111 Miffed Microbio...
Miffed Microbiologist's picture

Absolutely stunning to hear how bad this is. I am sure those globalists have a nice stash of unadulterated meds for their own personal use. I have heard drug cutting is a severe problem globally and am not sure if we are seeing this in this country yet. When people start to die I'm sure it will wake people up but to then rebuild our manufacturing base again even in a good political climate will certainly not happen overnight.

I commonly see people depending on 15+ meds for their survival, mostly due to their own poor life choices. Any serious disruption in supply would be disastrous. And these people often pay more than $1500 monthly including subsidies. What a potential nightmare.

Miffed

Thu, 11/06/2014 - 03:07 | 5418592 kareninca
kareninca's picture

Seek, I last bought prednisone for my dog 10 months ago (from Foster and Smith).  I just bought more, and the price has doubled.

Thu, 11/06/2014 - 00:26 | 5418332 junction
junction's picture

The correct word is "cornering" as in cornering the market.  Until two years ago, there was never a shortage of digoxin, the generic digitalis heart medication.  Then the price started spiking, sometimes jumping 20 fold for a short time.  Pharmacists are well aware of these generic drug price spikes.  The FDA bureaucrats collect their salaries and let the drug companies rip off consumers and Medicare.

Happy Guy Fawkes Day!

----

(excerpt)

At Toy's pharmacy, the cost of a bottle of the generic heart medication digoxin shot up from $131 in September to $989 a month later for the same dosage. He said tetracycline, an antibiotic used to treat bacterial infections, rose from $31 for a specific dosage to $450 over the past year.

No explanation for cost

In some cases, the increases can be explained by a manufacturing problem that puts the drug in short supply or a shortage of a key raw material used to make the medication. But in many of the cases, observers say, the extreme jump in price comes without an explanation and seems to make no sense.

 

http://www.sfgate.com/health/article/Prices-soar-for-some-generic-drugs-...

 

Thu, 11/06/2014 - 03:07 | 5418593 Marco
Marco's picture

The generic producers are simply colluding and merging ... and the barrier to entry for the production most of these drugs is too high for competition to form in the short term (excepting the simple stuff like Saline and dextrose solutions, which seems to be more the result of government being slow in certifying new players).

Time for some trust busting.

Thu, 11/06/2014 - 03:12 | 5418598 kareninca
kareninca's picture

At that price I should start growing foxgloves (the flower digitalis comes from) in planters.

Thu, 11/06/2014 - 01:49 | 5418484 lasvegaspersona
lasvegaspersona's picture

1% lidocaine was impossible to get for several months too...these shortages are likley huge issues of mismanagement...utter inexcusable incompetence.

Thu, 11/06/2014 - 09:19 | 5418977 drdolittle
drdolittle's picture

Their have been shortages of lots of meds. There were increased inspections by the FDA and many places didnt pass inspection (doesn't mean it's not safe, a lot of fda and jaco requirements are retarded). It's another way to restrict payment or, fuck up the healthcare system.

Wed, 11/05/2014 - 22:48 | 5417936 TruthInSunshine
TruthInSunshine's picture

As mentioned in another thread, a client of mine is a wholesale distributor of chemicals used in Pharma industry and says he's never seen the shortage of critical med chems that now exists, for "mysterious reasons," in over 30 years.

At retail level, this means people literally can't get prescriptions filled (actually bad in a few cases).

This extends to pharmaceutical grade salts, such as clavulanate potassium (used in antibiotics as other salts as catalysts), salts that increase shelf-life, stabilize molecules, basic saline, and salts used as mood stabilizer class drugs in and of themselves (lithium is a salt).

In some cases, the DEA sets quotas on production of chemicals each year (e.g. amphetamines), and this failure of the DEA to increase quotas contributes to the problem, but ask family & friends about difficulty in filling Rx's (if you haven't experienced it 1st hand).

Some of the most common & even necessary meds are in historically short supply right now - we're talking every class of meds.

Fri, 11/07/2014 - 19:59 | 5425670 Buckaroo Banzai
Buckaroo Banzai's picture

Why the fuck does the DEA set manufacturing quotas? What is the retarded rationale for that?

Wed, 11/05/2014 - 22:10 | 5417876 q99x2
q99x2's picture

I thought Obama cured Ebola prior to the election. You mean that stuff is still around.

Wed, 11/05/2014 - 22:12 | 5417886 MayIMommaDogFac...
MayIMommaDogFace2theBananaPatch's picture

Just as one can't help but wonder: why and how can it be so difficult to restock on what is essentially plastic containers filled with water and 0.9% of salt thrown in?

Yup.  Uh-huh.  That's exactly what I was thinking.

Wed, 11/05/2014 - 22:20 | 5417922 johnQpublic
johnQpublic's picture

Same reason they cant restock .22?

Wed, 11/05/2014 - 23:02 | 5418092 NoDebt
NoDebt's picture

Several members on here often say "nothing changes until supply lines break."

Jesus, could it ACTUALLY be happening?

(Agreed on the shortage of 22LR.  I use Gunbot.net to find what I need, but just walking into your local gun store these days is usually an exercise in futility.)

Wed, 11/05/2014 - 22:29 | 5417967 seek
seek's picture

Well, when the FDA shows up and shuts down Baxter's production, well that's the first step in making it hard. (Apparently for good cause, btw, as it's been reported there was shit floating around in multiple lots of Baxter's saline and dextrose and that they appear to have issues making anything pure. Why you'd put a IV factory in a shithole like Puerto Rico... you'll have to ask them.)

Wed, 11/05/2014 - 22:41 | 5418013 Fix-ItSilly
Fix-ItSilly's picture

For the same reason many pharma companies are in Puerto Rico - tax haven.

Wed, 11/05/2014 - 22:45 | 5418030 erkme73
erkme73's picture

someone doesn't listen to the Schiff show/blog...

Wed, 11/05/2014 - 22:13 | 5417887 ebworthen
ebworthen's picture

Making Cialis must be much more profitable.

Wed, 11/05/2014 - 22:14 | 5417891 disabledvet
disabledvet's picture

Why do I get the feeling everything is about to cost more again.

Wed, 11/05/2014 - 22:28 | 5417953 Government need...
Government needs you to pay taxes's picture

Good to know that the FEMAcamps will be well stocked with saline.  

Thu, 11/06/2014 - 15:57 | 5420807 mkkby
mkkby's picture

Maybe, but the guards will be keeping it for payments under the table.

Wed, 11/05/2014 - 22:29 | 5417958 ceilidh_trail
ceilidh_trail's picture

The thing about stockpiling is that most of these have stability/sterility labels of only a few years out. This HAS been an interesting year of one med shortage after another... Kliguy is accurate.

Wed, 11/05/2014 - 22:30 | 5417962 IndianaJohn
IndianaJohn's picture

A shortage of salt-water can be relieved by looking at the globe, and then going towards the blue.

Thu, 11/06/2014 - 01:46 | 5418475 Miffed Microbio...
Miffed Microbiologist's picture

Well, I wouldn't want to inject that without some major cleaning. Especially the Pacific.

Miffed

Thu, 11/06/2014 - 04:55 | 5418684 Parrotile
Parrotile's picture

Endotoxin - LOTS of it. Along with all the other interesting stuff, that gets through a 0.22 micron "sterilising" filter.

Apart from it being too hypertonic by far.

Wed, 11/05/2014 - 22:33 | 5417973 Sizzurp
Sizzurp's picture

Shortages are often the result of price fixing.  In this case, the gov. and insurance companies fix re-imbursment rates to hospitals and other medical practice facilities.  This often makes margins razor thin or nonexistent.  You can't make up a unit loss with more volume.   A healthcare bureaucracy has evolved, and with it a quagmire of regulation.  There are loads of folks with their hands in the healthcare cookie jar who provide no useful function, and they have nothing to do with the actual delivery of care.

Wed, 11/05/2014 - 22:39 | 5418004 LibertarianMenace
LibertarianMenace's picture

"Just as one can't help but wonder: why and how can it be so difficult to restock on what is essentially plastic containers filled with water and 0.9% of salt thrown in?"

Any sensible person would think so. But then they would not have experience dealing with the FDA. Drug prices through the roof? I witness daily the costs that are incurred by FDA regulatory overkill. The procedural complexity rivals that of a microprocessor design. So it's no shock that regulatory enforcement could complicate something so simple like the production of salt water and to such a degree that a shortage (or its corollary, high prices) is the result.

 

Send the FDA down to the southern border with their rule book, and overnight they could create a shortage of illegal border crossings.

Wed, 11/05/2014 - 22:44 | 5418023 MedicalQuack
MedicalQuack's picture

Add nitroglycerin IV to the list too, again another staple for the ER room and Baxter again as the only producer. 

http://ducknetweb.blogspot.com/2014/03/nitroglycerin-iv-is-latest-drug.html

Not enough money in it just line saline I suppose. 

Wed, 11/05/2014 - 22:43 | 5418027 tmosley
tmosley's picture

How can something you can literally make in your house in five minutes in shortage?

Oh yeah, the government is in charge of it.

Wed, 11/05/2014 - 22:46 | 5418035 CaptOveur
CaptOveur's picture

There is a simple solution. Put the DEA in charge of saline prohibition and it will be available on every street corner. While you're at it, put the FDA in charge of making heroine safe and inexpensive...

Wed, 11/05/2014 - 22:57 | 5418056 americanspirit
americanspirit's picture

Saline IV is simply a technology scam to promote people's dependence on the medical industry. You can accomplish just about the same thing by drinking a salty glass of water. Tip - use sea salt, not Mortons. Sea salt is @ 85% sodium chloride and 15% a mix of other mineral salts - much better for you than the Pig Pharma saline drip.

But if you go to a hospital and they put an IV into your veins they can charge you thousands of dollars. A simple saline nasal wash will also accomplish about the same thing as an IV saline drip if you don't like salty drinks. ( I prefer a Marguerita, heavy on the salt.).

But with self-treatment you don't get all those beautiful nurses and handsome doctors hovering around you while they are thinking about how you are paying their Mercedes and Timeshare bills. They are all so cute and loveable. Who could possibly resist? Please stick me Bro!

Wed, 11/05/2014 - 23:44 | 5418152 pupdog1
pupdog1's picture

But with self-treatment you don't get all those beautiful nurses and handsome doctors hovering ...

In my local major hospital, the doctors are almost all foreigners, speak about four words of English, and travel  their rounds in packs of about 50, I suspect so they can all say they visited you on a "consult" and thereby get their hand in your wallet.

Thu, 11/06/2014 - 02:59 | 5418451 TruthInSunshine
TruthInSunshine's picture

Drip IV saline is necessary because it allows for hydration & electrolyte balance in bed-ridden patients without forcing med staff to consume time/resources force dispensing cups of electrolyte fortified liquids to patients, many of whom are not ambulatory, have breathing, digestion, throat/larynx issues, renal issues, might be intubated, on ventilators, or who have many, many other serious issues that make drinking liquids regularly (or at all) impractical.

Without drip IV saline that's passively absorbed on a continuous basis, in amounts that are reliably absorbed into all tissues, with proper electrolyte balance, there'd be significantly more medical complications for hospital patients, including dehydration, renal failure, toxicity from (undiluted) meds, etc.

Wed, 11/05/2014 - 23:52 | 5418257 Cthonic
Cthonic's picture

This problem predates the Ebola outbreak.  It is an artificial restriction of supply caused by group purchasing organizations and FDA's ridiculous certification process that no new providers are willing to overcome.  And don't forget all the celebrities and wannabees who think it is cool to take their vitamins intravenously.

http://www.advisory.com/daily-briefing/2013/08/27/the-secret-of-salines-...

Thu, 11/06/2014 - 00:00 | 5418269 pupdog1
pupdog1's picture

In the last 100 years, Americans invented the airplane, the automobile, atomic energy, the transistor, the integrated circuit, the laser, cheese in a pressurized can, and we walked on the moon.

Now you're telling me we can't add salt to water, probably boil it, and stick it in a plastic bag?

The feds couldn't say "You make tons of the basic shit, or we don't reimburse your ass for the fancy shit"?

Congressgrifting.

 

Thu, 11/06/2014 - 00:55 | 5418396 McMolotov
McMolotov's picture

Nothing says "American Exceptionalism" like Easy Cheese, bitchez.

Thu, 11/06/2014 - 05:23 | 5418704 Lore
Lore's picture

Don't get me started on the cheese / dairy cartel.

Thu, 11/06/2014 - 01:38 | 5418460 Bumbu Sauce
Bumbu Sauce's picture

Part of the problem is the availability of USP grade salts to add to the USP water to create the saline solution. There is little to no money to be made in the salts manufacturing business. profit margins are razor thin. Sue there are specialty salts that demand a decent profit margin, but the simple salts like sodium chloride, sodium phosphates, sodium sulfates are just commodities. One of the largest domestic producers of these salts just got out of the business.

The other issues related to this shortage are all regulatory. Keeping the fda, OSHA, epa happy(compliance costs) is an extremely expensive endeavor. They regulators can change rules overnight on you. Every regulation has a cost of compliance, essentially a tax. this is why manufacturing is all headed overseas. I'd love to dig into this more but typing on my phone just sucks.

Thu, 11/06/2014 - 09:41 | 5419087 Bumbu Sauce
Bumbu Sauce's picture

People have no idea how regulated the pharmeceutical industry is.  You have a train(production line) set up to make product X.  Well, a hand operated ball-valve on a line goes bad and needs to be changed but there aren't any readily available.  None that match the "authorized" valve are in stock, and the replacement will have to be shipped from Asia.  You can't just slap any valve into the line so that production may resume.  The process would have to go thru something called "Change Control."  Everything must be documented, and reviewed by independent factions within the same company.  All of this takes time and money.  Meanwhile your production line is idle and so is the line's workforce.

That is just one simple example of why manufacturing, especially of pharmaceuticals, is moving overseas.

Thu, 11/06/2014 - 10:26 | 5419266 overmedicatedun...
overmedicatedundersexed's picture

tcn, erythromycin, doxycycline all generic for decades have seen 1000 fold price incr..well we shipped our jobs making these drugs overseas, for cheap, LOL..now the limited number of co's overseas making these can control the price..cost less until it does not is what NWO free trade comes to in the end.

Thu, 11/06/2014 - 10:39 | 5419320 Bumbu Sauce
Bumbu Sauce's picture

Forest for the trees in the short term for the Board and investors right?

Almost 100% of the antibiotics we use in America are produced in China.

Almost 100% of flu vaccines available in America are produced overseas.

We've regulated ourselves into imbecility.

Thu, 11/06/2014 - 20:14 | 5421851 LibertarianMenace
LibertarianMenace's picture

+1000

I never thought the term "Change Control" could follow me home, but hell, there it is. If the general public ever understood the regulatory environment that exists in the medical manufacturing industry, they'd call a cop. By the way, typing on a tablet isn't much better.

Thu, 11/06/2014 - 02:09 | 5418516 glenlloyd
glenlloyd's picture

There's a lot of Fema coffins out there that need to be used....

Thu, 11/06/2014 - 03:07 | 5418594 flyonmywall
flyonmywall's picture

Here you go. For a measly $18 per liter. Only 1 case in stock.

http://www.amazon.com/Growcells-MSDW-1000-12-Sterile-Saline-Solution/dp/...

I'm sure the FEMA camps are well stocked for that pure saline, nuclease free enema.

 

Thu, 11/06/2014 - 04:08 | 5418621 joego1
joego1's picture

So I boil salt in water, filter it, and put it in a sterile container with some sort of drip cock mechanism to a syringe. Can I make saline in the field? Not very well, but if someone is dying and hope and change is just around the corner.... What the Hell?

And a nice lady give the solution,

http://www.diynatural.com/make-saline-solution/

Thu, 11/06/2014 - 04:17 | 5418649 kareninca
kareninca's picture

This is an important article.  There ought to be be more readers and comments.

Thu, 11/06/2014 - 11:02 | 5419451 conscious being
conscious being's picture

By the time you turn 40 you should have learned how to be you own doctor.

Thu, 11/06/2014 - 04:55 | 5418682 basho
basho's picture

another example of exceptionalism.

lol

Thu, 11/06/2014 - 05:09 | 5418693 CHX
CHX's picture

Wake me when they put silver on there, K ?

Thu, 11/06/2014 - 07:42 | 5418827 youngman
youngman's picture

I read all of these comments..and many are from people in the medical field...but no one seemed to know what the problem was caused by...that is amazing....

Thu, 11/06/2014 - 08:16 | 5418884 Pumpkin
Pumpkin's picture

Isn't saline salt water?  How the fuck do you run out of salt water?

Thu, 11/06/2014 - 08:46 | 5418928 Last of the Mid...
Last of the Middle Class's picture

I just noticed this week that Tetracycline went from $9/100 to $889/100 in one price jump while on Ebay medicinal grade is available by the kilo at cheap prices. There is a lot more going on that just stock piling. Someone has been given the Okay to raise generic prices a thousand percent or so with no justification blaming it on FDA regs or something so stupid. The cost to mom and pop is just now coming down the pipe line and Obamacare is one of the prime suspects. The price increases we're seeing or like war time profiteering and it's everwhere.

Thu, 11/06/2014 - 08:50 | 5418932 earnulf
earnulf's picture

Until you actually try to "produce" it, you don't realize how many government hands have to "sign off" on what you are doing.        And even if you THINK you are doing everything by the book ,they can change the rules and slap fines on you that wipe out any and all "profit" you may have made or thought you could make for years down the road.

OSHA fines alone can run into the tens of thousands of dollars, PER INCIDENT.

You can't start a business without a hefty bank balance or nest egg and given all the hoops that you would have to jump through when you hire your first worker, why would you?

But you can bet things are only going to get worse as Congress returns for the Repubican Agenda.    Trickle down will likely become Golden Showers and Free Fertilizer once again.     As long as the 1% have thier saline, who cares what the other 99% have.    Can't afford your meds?    Don't expect Uncle Sam to help or any of the companies since there is no profit in it.   Besides, lifespans were getting too long anyway and this will help the pension squeeze so that companies won't have to increase their contributions while getting squat on the dollar in interest!

Thu, 11/06/2014 - 09:34 | 5419050 Bumbu Sauce
Bumbu Sauce's picture

+1 the first half, and -100 the second...

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